Neutropenic Enterocolitis in a Metastatic Seminoma Patient With Streptococcus gallolyticus Bacteremia

TL;DR

This case report describes a rare instance of neutropenic enterocolitis linked to Streptococcus gallolyticus in a patient with metastatic seminoma.

Contribution

The paper uniquely associates Streptococcus gallolyticus with neutropenic enterocolitis in a metastatic seminoma patient.

Findings

The patient showed symptoms of NEC, fever, and Streptococcus gallolyticus bacteremia.

Treatment with antibiotics and filgrastim resolved the neutropenia and led to recovery.

This is the first reported case linking Streptococcus gallolyticus to NEC.

Abstract

Neutropenic enterocolitis (NEC), also referred to as typhlitis, is a condition associated with a high mortality risk and primarily manifests in immunocompromised patients. It is characterized by ulceration, edema, and hemorrhage affecting the bowel wall. The underlying cause of NEC is postulated as an immunocompromised condition that facilitates bacterial infiltration through compromised bowel mucosa. The high mortality rate is attributable to bowel necrosis, culminating in perforation and sepsis. This report describes a case involving a patient with metastatic seminoma who exhibited seizure-like activity, fever, Streptococcus gallolyticus bacteremia, and NEC. The patient underwent treatment involving broad-spectrum antibiotics and filgrastim. The patient's neutropenia resolved leading to discharge on oral antibiotics. The case reported is unique, as it links NEC to Streptococcus gallolyticus and seminoma. Streptococcus gallolyticus has not been previously associated with NEC.

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